Research using the North Carolina Kidney Disease Study has largely been completed. Most recently we evaluated associations between self-reported job history and specific occupational exposures, including solvents, dusts, metals and silica with risk for kidney disease. Our study included 548 cases with renal dysfunction confirmed by hospital chart review and 514 matched population controls. Specifically, we evaluated chronic kidney disease in relation to work in agriculture and manufacturing jobs in the presence of dusty conditions. Using data from the US National Health and Examination Survey (NHANES), we studied factors associated with antinuclear antibodies (ANA, including vitamin D and medication use We also studied the the relationship of ANA with mortality risk (all-cause, cardiovascular disease and cancer). Findings from this work motivated additional analysis of ANA in relation to vitamin D in middle age and older adults, using data from the Baltimore Longitudinal Study of Aging. This work was carried out in collaboration with investigators from the National Institute on Aging (NIA). We are also using the BLSA to study changes in ANA levels over time, explore associations between vitamin D and other factors with ANA levels and trajectories, and evaluate whether ANA levels are associated with telomere shortening over time. A manuscript was submitted that describes associations of ANA with age and health status. A paper on ANA and vitamin D levels was published and a paper om telomere length and telomere length change (a marker of immune aging) is being drafted. With Dr. Kamel's retirement, our work on ALS has been winding down. Research was carried in two settings - using linked registry data in Sweden and in a case-control study nested within a registry of ALS in U.S. Veterans. As part of an NIH, Karolinska Institute partnership, we worked with a doctoral student who studied risk factors for Amyotrophic lateral sclerosis. Using data from Swedish registries, she found both higher and lower risk of ALS associated with several industries and occupations, with findings largely consistent with earlier reports. She also found an association between fractures and ALS that we speculate is largely due to early effects of incipient ALS. We also reported associations between specific military-related exposures and experiences and risk for ALS in our study of US veterans included in a national registry of ALS patients. We also evaluated links between blood levels of metals and ALS risk and survival. We found that selenium and zinc levels were inversely associated with ALS risk whereas copper was positively associated with increased risk. We also reported that body mass index had an association with ALS prognosis that was not explained by reverse causality.